Limited information is available about the transfer of articaine into breast milk and the associated risks to breastfed infants. As such, health care providers and patients often forgo local anesthesia, postpone dental treatment, or stop breastfeeding after receiving articaine. The authors aimed to evaluate the safety of articaine use in mothers who are breastfeeding by means of examining its pharmacokinetic properties in breast milk and assessing the potential risks to breastfed infants.

Twelve breastfeeding mothers were randomly assigned to 2 groups and received an injection of 4% articaine (containing 68 mg of articaine) via supraperiosteal infiltration. Group A provided milk samples at various times postadministration, and milk output from group B was measured over the first 3 hours postadministration.

The peak concentration of articaine in breast milk was 256.5 ng/mL at 0.25 hours, and declined to 12.9 ng/mL at 3 hours postadministration. The amount of articaine transferred to breast milk after 3 hours was calculated as 1.12 μg. Pharmacokinetic modeling predicted that the maximum plasma exposure in infants was 0.19 ng/mL, far below toxicity thresholds.

The study findings suggested that breastfeeding mothers can safely resume breastfeeding within 1 through 3 hours after administration of articaine, as the predicted infant exposure was considerably below the concentrations producing a pharmacologic effect.